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G Vázquez Mata

Publications and source records attributed to G Vázquez Mata.

9 recordsLinked to original sources
PubMed2001

[Severity assessment by APACHE III system in Spain].

BACKGROUND: To assess the performance of the prediction equation of the APACHE(Acute Physiology Age and Chronic Health Evaluation) III prognostic scoring system when applied in Spain. PATIENTS AND METHOD: Prospective multicenter cohort study that included 10786 adult patients from 86 Spanish intensive care units (ICU). Data collection during first 24 hours of admission: acute physiology score, age and comorbilties,for calculating APACHE III score; treatment location prior to ICU admission and main diagnosis admission category for applying the mortality prediction equation of APACHE III system. Main outcome was observed hospital mortality. RESULTS: Age was 57.74 (0.16); 68% males. Non-operative patients represented 76% of sample. APACHE III score was 53.75(0.26); observed and predicted hospital mortality were 21.2% and 19.8% respectively, with a standardized mortality ration of 1.07. The Chi2 Hosmer-Lemershow statistic was (H) 135.6, (C) 133.91: p < 0.001. The area under the Receiver Operating Curve (ROC) was 0.808, and correct classification at mortality risk of 50% was 82%. Uniformity of fit was better for non-operative diagnoses and for patients admitted from the emergency area. Calibration was excellent for risk lower than 60% but slightly underestimated observed risks above this level. CONCLUSIONS: The American APACHE III equation fit well when applied to Spanish critical patients but with limitations. Discrepancies could be attributed to differences in case-mix and variations in practice style.

APACHE↗
PubMed1993

Thrombolytic treatment for massive thrombosis of prosthetic cardiac valves.

OBJECTIVE: To present the efficacy of thrombolytic treatment in place of emergency surgery in massive thrombosis of prosthetic cardiac valves (TPCV), and to set out the diagnostic criteria and the patients' evolution. DESIGN: Retrospective study. SETTING: Coronary Care Unit of a Spanish reference hospital. PATIENTS: 7 patients admitted into the ICU with 10 episodes of TPCV and with advanced functional class. INTERVENTIONS: The diagnosis of TPCV was arrived at through clinical data and was confirmed by Doppler-echocardiography before treatment. Thrombolytic treatment (streptokinase, urokinase or rt-PA) was used. The analysis of paired samples between the data before and after treatment was used. MEASUREMENTS AND RESULTS: All the patients underwent an improvement in their clinical condition. A reduction of sPAP and in the mean transprosthetic gradient and an increase in the effective valvular area was achieved. Four patients needed surgical intervention during their follow-up. No case required emergency surgery. One patient died after surgery and the other 6 patients are alive after follow-up of 6-33 months. With the fibrinolytic treatment hemorrhagic complications were always controlled. None of the treated patients presented embolic complications. CONCLUSIONS: Fibrinolytic treatment is the recommended initial treatment in cases of massive TPCV. When fibrinolysis is only partially successful, reoperation can be performed at lower risk. Doppler echocardiography is fundamental in the diagnosis of TPCV and in monitoring the response to fibrinolytic treatment.

Adult↗
PubMed1986

Theophylline binding to plasma proteins in patients with chronic obstructive pulmonary disease.

The binding of theophylline to plasma proteins was studied in samples from healthy adults at different pH values and drug concentrations and in samples from patients with chronic obstructive pulmonary disease (COPD). Binding determinations were performed by ultrafiltration and drug concentrations were measured by high performance liquid chromatography. Total plasma levels of theophylline did not influence the degree of the binding. The percentage of bound theophylline was positively correlated with pH both in vitro (r = 0.998, p less than 0.005) and in vivo (r = 0.579, p less than 0.005). Mean theophylline binding values in vivo (mean 56.3 +/- 12.5) and in vitro (mean 48.3 +/- 9.4) were significantly different. The increase in theophylline free levels detected in COPD patients was partially dependent on low pH values but the influence of other factors must also be considered. The therapeutic implications of altered theophylline binding are discussed.

Adult↗